Obamacare crashes into Romneycare

Massachusetts created a Romneycare-inspired template for President Barack Obama’s health reform effort. Now, as the Bay State is struggling to upgrade for the Obamacare era, its enrollment system is buckling under technical glitches like those that hobbled HealthCare.gov.

State officials are increasingly concerned that thousands of Massachusetts residents seeking coverage are lost in a wilderness of misfiled applications and cybermalfunctions. Now, they’re moving ahead with a labor-intensive backup plan aimed at making sure that no one loses coverage when Obamacare starts in January.

Massachusetts’s experiment with health reform — led by Gov. Mitt Romney in 2006 — has long been a White House talking point about what America could look like under Obamacare. President Barack Obama flew to Boston in October to reassure the nation that his own health law would turn out just fine, despite its disastrous rollout. Massachusetts built its exchange in 2007, with its own balky rollout, and the state now boasts the country’s lowest uninsurance rate.

That narrative is under threat. Massachusetts is struggling to rebuild its exchange, known as the Connector, to comply with the Affordable Care Act. New federal subsidy levels and broader Medicaid coverage mean that tens of thousands of people have to enroll or re-enroll but are hitting those glitches. That’s led to a blame game.

“Massachusetts showed the nation that near-universal coverage is doable, affordable and significantly helps the uninsured access needed care. We were the model for the ACA. Unfortunately, the Connector’s current performance plays into the opposition’s narrative that the ACA is unworkable, and government is ineffective,” said Jon Kingsdale, who led the exchange under both Romney and Democratic Gov. Deval Patrick from 2006-10. “I trust that the Connector’s dedicated staff and independent board of directors will explain what went wrong here and fix it.”

State officials insist the rampant tech woes won’t result in people going uncovered. For instance, they’re letting nearly 100,000 low-income people who were supposed to transition from the old exchange to the new one stay on their existing plans through March, while officials work through technical failures.

“I feel confident that we will protect our gains in coverage, protect coverage for people who have it today and open up avenues to subsidized coverage for the newly eligible,” said Glen Shor, Patrick’s budget chief and the chairman of the Connector board.

Connector officials have blamed the exchange’s flawed enrollment system on the state’s IT contractor, CGI — which was also the lead contractor for the federal HealthCare.gov. And that, Shor said, had forced officials to scramble for a Plan B.

Asked about the criticism, CGI spokeswoman Linda Odorisio said in a statement, “CGI and its resources are dedicated to delivering continuous improvements in system performance and the user experience for the Massachusetts Health Connector.”

Connector board member Ian Duncan, an actuary, said he’s “puzzled” about why the state built an enrollment system from scratch rather than pursue an exemption from Obamacare to retain its existing, well-functioning enrollment platform.

“Clearly, Obamacare … is orders of magnitude more complicated than Massachusetts reform — and maybe Mitt Romney was right,” Duncan said. “Maybe we really should’ve learned from the lessons of Massachusetts.”

At a Dec. 12 meeting the staff of the Massachusetts Connector noted that visitors to the website were encountering “recurring problems in account creation log-in, slow performance, time-outs, random and sporadic error messages.” They also reported problems in determining eligibility for tax credits and processing enrollments.

Although 95,000 online accounts had been created and 35,000 applications for coverage submitted by Dec. 11, just 1,400 applicants finished the process. It’s unclear how many have paid their first premium. “Given where we are on the timeline, it is evident that we will not be able to leverage the new website and IT system as intended to support enrollment into ACA-compliant coverage for [Jan. 1],” according to a Connector staff report delivered to the agency’s board.

The Connector’s backup plan involved building a “stand-alone” enrollment system and beginning a manual transfer of application files to insurers. “If we are not able to process certain applications through this workaround we plan to provide [applicants] temporary access to coverage” through existing programs, the staff noted.

A Patrick spokeswoman said that “despite the underperformance of the IT vendor responsible for the Connector website” the governor remains confident that the state will expand, not contract, insurance Jan. 1 and build on the successes of the state initiative.

“It’s working in Massachusetts,” Patrick told Obamacare supporters in Washington last month. “Thanks to President Obama, it will work for America.”

Romney during the presidential campaign defended the Massachusetts law while insisting that it shouldn’t be forced on the whole nation.

“If things continue on the trajectory they’re on now, people will look back in several years on the state solution that Gov. Romney implemented in the commonwealth and have fond memories,” said Ryan Williams, an aide to Romney while he was governor and during the campaign. “Unfortunately, there might be side effects for people who might be trying to get insurance because of the ineffective system that unfortunately has replaced it.”